Development and validation of a new prognostic immune-inflammatory-nutritional score for predicting outcomes after curative resection for intrahepatic cholangiocarcinoma: A multicenter study

作者全名："Zhu, Jiang; Wang, Denghui; Liu, Chang; Huang, Rui; Gao, Fengwei; Feng, Xuping; Lan, Tian; Li, Hui; Wu, Hong"

作者地址："[Zhu, Jiang; Gao, Fengwei; Feng, Xuping; Lan, Tian; Wu, Hong] Sichuan Univ, West China Hosp, Liver Transplantat Ctr, Chengdu, Peoples R China; [Liu, Chang] Sichuan Univ, West China Hosp, Dept Liver Surg, Chengdu, Peoples R China; [Liu, Chang] Chengdu ShangJin NanFu Hosp, Dept Hepatopancreatobiliary Minimal Invas Surg, Chengdu, Peoples R China; [Li, Hui] Chongqing Univ Canc Hosp, Dept Hepatobiliary Pancreat Tumor Ctr, Chongqing Key Lab Translat Res Canc Metastasis & I, Chongqing, Peoples R China; [Gao, Fengwei] Peoples Hosp Leshan, Dept Hepatobiliary Surg, Leshan, Peoples R China; [Huang, Rui] Zhejiang Univ, Affiliated Hosp 2, Dept Anesthesiol, Sch Med, Hangzhou, Peoples R China; [Wang, Denghui] Chongqing Med Univ, Dept Endocrine & Breast Surg, Affiliated Hosp 1, Chongqing, Peoples R China"

通信作者："Wu, H (通讯作者)，Sichuan Univ, West China Hosp, Liver Transplantat Ctr, Chengdu, Peoples R China.; Li, H (通讯作者)，Chongqing Univ Canc Hosp, Dept Hepatobiliary Pancreat Tumor Ctr, Chongqing Key Lab Translat Res Canc Metastasis & I, Chongqing, Peoples R China."

来源：FRONTIERS IN IMMUNOLOGY

ESI学科分类：IMMUNOLOGY

WOS号：WOS:000967966000001

JCR分区：Q1

影响因子：5.7

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：intrahepatic cholangiocarcinoma; immunity; inflammation; nutrition; prognosis; nomogram

摘要："BackgroundImmune function, nutrition status, and inflammation influence tumor initiation and progression. This was a retrospective multicenter cohort study that investigated the prognostic value and clinical relevance of immune-, inflammatory-, and nutritional-related biomarkers to develop a novel prognostic immune-inflammatory-nutritional score (PIIN score) for patients with intrahepatic cholangiocarcinoma (ICC). MethodsThe clinical data of 571 patients (406 in the training set and 165 in the validation set) were collected from four large hepato-pancreatico-biliary centers of patients with ICC who underwent surgical resection between January 2011 and September 2017. Twelve blood biomarkers were collected to develop the PIIN score using the LASSO Cox regression model. The predictive value was further assessed using validation datasets. Afterward, nomograms combining the PIIN score and other clinicopathological parameters were developed and validated based on the calibration curve, time-dependent AUC curves, and decision curve analysis (DCA). The primary outcomes evaluated were overall survival (OS) and recurrence-free survival (RFS) from the day of primary resection of ICC. ResultsBased on the albumin-bilirubin (ALBI) grade, neutrophil- to- lymphocyte ratio (NLR), prognostic nutritional index (PNI), and systemic immune- inflammation index (SII) biomarkers, the PIIN score that classified patients into high-risk and low-risk groups could be calculated. Patients with high-risk scores had shorter OS (training set, p < 0.001; validation set, p = 0.003) and RFS (training set, p < 0.001; validation set, p = 0.002) than patients with low-risk scores. The high PIIN score was also associated with larger tumors (>= 5 cm), lymph node metastasis (N1 stage), multiple tumors, and high tumor grade or TNM (tumor (T), nodes (N), and metastases (M)) stage. Furthermore, the high PIIN score was a significant independent prognostic factor of OS and RFS in both the training (p < 0.001) and validation (p = 0.003) cohorts, respectively. A PIIN-nomogram for individualized prognostic prediction was constructed by integrating the PIIN score with the clinicopathological variables that yielded better predictive performance than the TNM stage. ConclusionThe PIIN score, a novel immune-inflammatory-nutritional-related prognostic biomarker, predicts the prognosis in patients with resected ICC and can be a reliable tool for ICC prognosis prediction after surgery. Our study findings provide novel insights into the role of cancer-related immune disorders, inflammation, and malnutrition."

基金机构："National Natural Science Foundation of China [82173124, 82103533, 81972747, 82203823]; Natural Science Foundation of Sichuan Province [2023NSFSC1877]; Natural Science Foundation of Chongqing [CSTB2022NSCQ-MSX0477]; China Postdoctoral Science Foundation [2022TQ0393]"

基金资助正文："Funding This work was supported by grants from the National Natural Science Foundation of China (82173124, 82103533, 81972747, and 82203823), the Natural Science Foundation of Sichuan Province (2023NSFSC1877), the Natural Science Foundation of Chongqing (CSTB2022NSCQ-MSX0477), and the China Postdoctoral Science Foundation (2022TQ0393)."